Sleep Related Questionnaires

Epworth Sleepines Scale (ESS)

Name of questionnaire Epworth Sleepines Scale (ESS)
Type of original questionnaire-description, age/population Measure of general level of sleepiness. The ESS asks people to rate their usual chances of dozing off or falling asleep in 8 different situations or activities that most people engage in as part of their daily lives, although not necessarily every day.
Number of items 8 questions
Number of domains/categories 1
Name of categories/domains   Propensity of falling asleep
Scaling of items  4-point scale (0 – 3)
Scoring available: with permission or free Free for individual users and non-funded academic research
Scoring test-retest reliability Total ESS scores are reliable in a test-retest sense over a period of months (p < 0.001). The ESS score is highly variable when administered sequentially to a clinical population being evaluated for a potential sleep related breathing disorder.
Scoring Internal consistency Cronbach’s alpha statistic = 0.88 – 0.74 in 4 different groups of subjects.
Validity The ESS had a statistically significant association with self-rated problem sleepiness but low correlation with mean sleep latency (r=0.51) or measures of sleep apnea severity.
Language English
Translations in other languages (if yes, then list the languages) Arabic, Croatian, French, German, Greek, Italian, Japanese, Korean, Mandarin, Norwegian, Persian, Portuguese, Serbian, Spanish, Thai, Turkish, Urdu
Developer name

Dr.Murray Johns

Developer contact information for permission

Dr Murray Johns
c/o Optalert Ltd
Level 3
Building 5, 658 Church Street
Richmond, Melbourne
Victoria, 3121
Telephone: +61 3 9425 5000
Facsimile: +61 3 9425 5001
Email: mjohns@optalert.com

MAPI Research Trust
PRO Information Support
27 Rue de la villette
69003 Lyon
Phone: +33 (0) 4 7213 6575
Fax: +33 (0) 4 7213 6682

Email: PROinformation@mapi-trust.org


Availability of questionnaire: needs permission from developer, cost or freely available Free for individual users and non-funded academic research; fee for funded research
Limitations No statistically or clinically significant association between Epworth scores and mean sleep latency  test, suggesting that the 2 tests  may evaluate different, complementary aspects of sleepiness.
Link to the questionnaire (if available)


Other comments  
Patient populations in who questionnaire has been validated Adults
References (including original publication, validity and reliability in different countries/languages, populations and long/short versions)

Original Publication:

Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991; 50-55.

Different Countries/Languages:

Sargento P1, Perea V, Ladera V, Lopes P, Oliveira J. The Epworth Sleepiness Scale in Portuguese adults: from classical measurement theory to Rasch model analysis. Sleep Breath. 2014 Nov 20.

Kum RO1, Ozcan M, Yurtsever Kum N, Yılmaz YF, Güngör V, Unal A. A new suggestion for the Epworth Sleepiness Scale in obstructive sleep apnea. Eur Arch Otorhinolaryngol. 2014 Aug 10.

Ahmed AE, Fatani A, Al-Harbi A, Al-Shimemeri A, Ali YZ, Baharoon S, Al-Jahdali H. Validation of the Arabic version of the Epworth Sleepiness Scale. J Epidemiol Glob Health. 2014 Dec;4(4):297-302.

Al-Abri M, Al-Hamhami A, Al-Nabhani H, Al-Zakwani I.
Validation of the Arabic Version of the Epworth Sleepiness Scale in Oman. Oman Med J. 2013 Nov;28(6):454-6.

Riachy M, Juvelikian G, Sleilaty G, Bazarbachi T, Khayat G, Mouradides C. [Validation of the Arabic Version of the Epworth Sleepiness Scale: Multicentre study]. Rev Mal Respir. 2012 May;29(5):697-704.

Surani AA, Ramar K, Surani AA, Khaliqdina JS, Subramanian S, Surani S. Validation of the Urdu version of the Epworth Sleepiness Scale. J Pak Med Assoc. 2012 Sep;62(9):986-8.

Wu S1, Wang R, Ma X, Zhao Y, Yan X, He J.
Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China. BMC Public Health. 2012 Oct 8;12:849.

Peng LL, Li JR, Sun JJ, Li WY, Sun YM, Zhang R, Yu LL.

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. [Reliability and validity of the simplified Chinese version of Epworth sleepiness scale]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Jan;46(1):44-9.

Chen NH, Johns MW, Li HY, Chu CC, Liang SC, Shu YH, Chuang ML, Wang PC. Validation of a Chinese version of the Epworth sleepiness scale. Qual Life Res. 2002 Dec;11(8):817-21.

Zhang JN, Peng B, Zhao TT, Xiang M, Fu W, Peng Y.
Modification of the Epworth Sleepiness Scale in Central China.
Qual Life Res. 2011 Dec;20(10):1721-6.

Sadeghniiat Haghighi K, Montazeri A, Khajeh Mehrizi A, Aminian O, Rahimi Golkhandan A, Saraei M, Sedaghat M.
The Epworth Sleepiness Scale: translation and validation study of the Iranian version. Sleep Breath. 2013 Mar;17(1):419-26.

Pecotic R, Dodig IP, Valic M, Ivkovic N, Dogas Z. The evaluation of the Croatian version of the Epworth sleepiness scale and STOP questionnaire as screening tools for obstructive sleep apnea syndrome. Sleep Breath. 2012 Sep;16(3):793-802.

Rosales-Mayor E, Rey de Castro J, Huayanay L, Zagaceta K.
Validation and modification of the Epworth Sleepiness Scale in Peruvian population. Sleep Breath. 2012 Mar;16(1):59-69.

Chica-Urzola HL, Escobar-Córdoba F, Eslava-Schmalbach J.
[Validating the Epworth sleepiness scale]. Rev Salud Publica (Bogota). 2007 Oct-Dec;9(4):558-67.

Ferrer M, Vilagut G, Monasterio C, Montserrat JM, Mayos M, Alonso J. [Measurement of the perceived impact of sleep problems: the Spanish version of the functional outcomes sleep questionnaire and the Epworth sleepiness scale]. Med Clin (Barc). 1999 Sep 11;113(7):250-5.

Sandoval-Rincón M, Alcalá-Lozano R, Herrera-Jiménez I, Jiménez-Genchi A. [Validation of the Epworth sleepiness scale in Mexican population]. Gac Med Mex. 2013 Jul-Aug;149(4):409-16.

Kopitovic I, Trajanovic N, Prodic S, Drvenica MJ, Ilic M, Kuruc V, Kojicic M. The Serbian version of the Epworth Sleepiness Scale. Sleep Breath. 2011 Dec;15(4):775-80.

Banhiran W, Assanasen P, Nopmaneejumruslers C, Metheetrairut C. Epworth sleepiness scale in obstructive sleep disordered breathing: the reliability and validity of the Thai version. Sleep Breath. 2011 Sep;15(3):571-7.

Kaminska M, Jobin V, Mayer P, Amyot R, Perraton-Brillon M, Bellemare F. The Epworth Sleepiness Scale: self-administration versus administration by the physician, and validation of a French version. Can Respir J. 2010 Mar-Apr;17(2):e27-34.

Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW.
The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath. 2011 Sep;15(3):377-84.

Bertolazi AN, Fagondes SC, Hoff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol. 2009 Sep;35(9):877-83.

Beiske KK, Kjelsberg FN, Ruud EA, Stavem K. Reliability and validity of a Norwegian version of the Epworth sleepiness scale. Sleep Breath. 2009 Mar;13(1):65-72.

Stavem K, Kjelsberg FN, Ruud EA. Reliability and validity of the Norwegian version of the Functional Outcomes of Sleep Questionnaire. Qual Life Res. 2004 Mar;13(2):541-9.

Izci B1, Ardic S, Firat H, Sahin A, Altinors M, Karacan I.
Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath. 2008 May;12(2):161-8.

Tsara V, Serasli E, Amfilochiou A, Constantinidis T, Christaki P. Greek version of the Epworth Sleepiness Scale. Sleep Breath. 2004 Jun;8(2):91-5.

Vignatelli L, Plazzi G, Barbato A, Ferini-Strambi L, Manni R, Pompei F, D'Alessandro R; GINSEN (Gruppo Italiano Narcolessia Studio Epidemiologico Nazionale). Italian version of the Epworth sleepiness scale: external validity. Neurol Sci. 2003 Feb;23(6):295-300.

Bloch KE, Schoch OD, Zhang JN, Russi EW. German version of the Epworth Sleepiness Scale. Respiration. 1999;66(5):440-7.

Takegami M, Suzukamo Y, Wakita T, Noguchi H, Chin K, Kadotani H, Inoue Y, Oka Y, Nakamura T, Green J, Johns MW, Fukuhara S. Development of a Japanese version of the Epworth Sleepiness Scale (JESS) based on item response theory.
Sleep Med. 2009 May;10(5):556-65.


Nishiyama TMizuno TKojima MSuzuki SKitajima TAndo KBKuriyama SNakayama M. Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders. Sleep Med. 2014 Apr;15(4):422-9.

Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review. Sleep Med Rev. 2014 Aug;18(4):321-31.

Baumgartel KL, Terhorst L, Conley YP, Roberts JM. Psychometric evaluation of the Epworth sleepiness scale in an obstetric population. Sleep Med. 2013 Jan;14(1):116-21.

Broderick JE, Junghaenel DU, Schneider S, Pilosi JJ, Stone AA. Pittsburgh and Epworth sleep scale items: accuracy of ratings across different reporting periods. Behav Sleep Med. 2013;11(3):173-88.

Ulander M1, Arestedt K, Svanborg E, Johansson P, Broström A. The fairness of the Epworth Sleepiness Scale: two approaches to differential item functioning. Sleep Breath. 2013 Mar;17(1):157-65.

Spira AP, Beaudreau SA, Stone KL, Kezirian EJ, Lui LY, Redline S, Ancoli-Israel S, Ensrud K, Stewart A. Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. Osteoporotic Fractures in Men Study. J Gerontol A Biol Sci Med Sci. 2012 Apr;67(4):433-9.

Updated by Helena Schotland, MD
The last date of update December, 2014